Appalachian Regional Hospitals, Inc.

DECISIONS OF NATIONAL LABOR RELATIONS BOARD Appalachian Regional Hospitals, Inc., Operator of June Buchanan Primary Care Center' Employer and United Steelworkers of America, AFL-CIO- CLC, Petitioner. Case 9-RC- 12020 November 16, 1977 DECISION AND DIRECTION OF ELECTION BY CHAIRMAN FANNING AND MEMBERS JENKINS AND MURPHY Upon a petition duly filed under Section 9(c) of the National Labor Relations Act, as amended, a hearing was held before Hearing Officer James E. Horner. Following the hearing and pursuant to Section 102.67 of the National Labor Relations Board Rules and Regulations and Statements of Procedure, Series 8, as amended, the Regional Director for Region 9 issued an order transferring this case to the Board for decision. Thereafter, the Employer filed a brief in support of its position. Pursuant to the provisions of Section 3(b) of the National Labor Relations Act, as amended, the National Labor Relations Board has delegated its authority in this proceeding to a three-member panel. The Board has reviewed the Hearing Officer's rulings made at the hearing and finds that they are free from prejudicial error. They are hereby affirmed. Upon the entire record in this case, the Board finds: 1. The Employer operates the June Buchanan Primary Care Center,2 a primary care center or outpatient clinic, near Hazard, Kentucky. The Employer is a Kentucky corporation which operates a total of 10 hospitals in the States of West Virginia, Kentucky, and Virginia. The parties stipulated and we find that the Employer's gross revenues exceeded $60 million during the year preceding the commence- ment of the hearing held herein and that, during the same period, the Employer's hospitals each pur- chased goods valued in excess of $50,000 outside their respective States and caused such goods to be shipped in interstate commerce to their respective hospitals. Based upon the above evidence, we find that the Employer operates a health care institution within the meaning of Section 2(14) of the Act, that the impact of its operations on commerce is sufficient to warrant assertion of jurisdiction, and that it will effectuate the purposes of the Act to do so. 2. The labor organization involved claims to represent certain employees of the Employer. 3. A question affecting commerce exists concern- ing the representation of employees of the Employer I The name of the Employer appears as amended at the hearing. 233 NLRB No. 85 within the meaning of Sections 9(c)(1) and 2(6) and (7) of the Act. 4. In its petition, as amended at the hearing, the Petitioner seeks to represent in a single unit all of the nonprofessional employees at the Employer's Haz- ard, Kentucky, facility, including all service, mainte- nance, technical, and business office clerical employ- ees, but excluding all professional and confidential employees, guards, and supervisors as defined in the Act. The Employer contends that the Petitioner's unit request is too broad and that the Board should find appropriate three separate bargaining units; namely, a service and maintenance unit, including dental and laboratory assistants, medical record clericals, pharmacy clericals, and dental clericals; a technical unit, including technicals and licensed practical nurses; and a business office clerical unit, including business office clericals and receptionists. There is no history of collective bargaining involving these employees, and the Petitioner has not indicated whether it is willing to represent these employees in a unit narrower in scope than the "wall-to-wall" unit that it has requested. The Center provides physician services, dental services, X-ray services, and laboratory services to individuals on an outpatient basis. The Center has no inpatient beds but does have beds available for use in the emergency room and postpartum beds for use in the delivery ward. If after initial care a patient is unable to return home, the patient is transferred to one of the area hospitals with inpatient services. The Center occupies approximately 12,000 square feet of space which is divided into distinct areas: physician or medical area, lobby, business office, laboratory, X-ray department, pharmacy, dental area, emergency room, and obstetrical unit. The Center has one skilled maintenance employee (stipu- lated to be a supervisor) who oversees the work of three janitors and a maid who provide custodial and minor maintenance services. In the health care area, the Center employs two physicians and three registered nurses (stipulated to be professionals), five licensed practical nurses, a radiology technician, and a laboratory assistant. In the clinical laboratory area there are a medical lab technician and one or two laboratory assistants. The pharmacy is staffed by a clinical pharmacist (stipulated to be a professional and a supervisor), two pharmacy technicians, and a clerk-typist. The dental department which functions semiautonomously is comprised of two dentists and a dental hygienist (stipulated to be professionals and supervisors), six dental therapists, a dental assistant, a receptionist, and a clerk-typist. The front office is staffed by a secretary to the administrator (stipulated 2 Hereafter also referred to as the Center. 542 APPALACHIAN REGIONAL HOSPITALS to be a confidential employee), a senior business office clerical (stipulated to be a supervisor),3 two business office clericals, three receptionists, and two medical record clerks. In sum, there are approxi- mately 33 nonprofessional employees. All of these employees are hourly paid, receive the same fringe benefits, and use common facilities. The overall day- to-day responsibility for all aspects of the Employer's operations, including labor relations, rests with the Center's administrator. As stated, Petitioner seeks a "wall-to-wall" unit of all nonprofessional employees. The Employer op- poses such an overall unit, claiming that separate units of service and maintenance, technical, and business office clericals constitute the only appropri- ate units. The record reveals, however, that many of the individuals that the Employer would place in the technical unit work in close association with and under the same supervision as individuals which it would place in the service and maintenance unit. For instance, in the dental area, the Employer would place the dental therapist in the technical unit but would place the dental assistant, dental receptionist, and dental clerk-typist in the service and mainte- nance unit. All of these individuals report to the same supervisors, work in the same area, and have integrated job functions. In the pharmacy area, the Employer would place the pharmacy technicians in the technical unit and the pharmacy clerk in the service and maintenance unit. These employees all report directly to the pharmacist, work alongside each other in the same area, and have integrated job functions. In the radiology department, the Employ- er would place the radiological technician in the technical unit but would place a laboratory assistant who works in the same area and does some X-ray work in the service and maintenance unit. In the clinical laboratory area, the Employer would place the laboratory technician in the technical unit while placing a laboratory assistant who works in that area in the service and maintenance unit. In Newington Children's Hospital, 217 NLRB 793, 794 (1975), we indicated that a combined unit of service, maintenance, and technical employees "may also constitute an appropriate unit"; 4 and in Nation- al G. South, Inc., a wholly owned subsidiary of National Living Centers, Inc., a wholly owned subsidiary of A RA Services, d/b/a Memorial Medical, 230 NLRB 976 (1977), we found a combined unit of service, maintenance, and technical employees to be appro- priate. Accordingly, under these circumstances, I This position is presently vacant. See. for example. Mount Airy Foundation, d, h ,a Mount Airv Psvchiatric Center, 217 NLRB 802 (1975); Marquette General Hospital, Inc., 218 NLRB 713 (1975); Family Doctor Medical Group, a Professional Corporation, 226 NLRB 118(1976). where the Petitioner seeks to jointly represent these employees, the service, maintenance, and technical employees work in the same areas, report to the same supervisors, have integrated job functions, and have substantial and frequent contact with each other, we find that they have a substantial community of interest with each other and constitute an appropri- ate unit. With regard to the business office clericals, the Petitioner would include them in the same unit as the service, maintenance, and technical employees, while the Employer contends they should be found to constitute a separate unit. Board precedent estab- lishes that business office clericals usually "share a community of interest separate and apart from other clerical employees in health care institutions whose work is more closely related to the functions performed by employees in the service and mainte- nance unit, and that such business office clerical employees are entitled to be represented in a separate bargaining unit." 5 In accordance with this precedent, the Employer would place the two medical record clerks in the service and maintenance unit, while contending that the five business office clericals are entitled to separate representation. The two medical record clerks in this case work very closely with other service, maintenance, and technical employees, but they also work very closely with the business office clericals. The medical record clerks have their own office from which they work with service, mainte- nance, and technical employees in maintaining patient records. However, they also spend 4 hours a day in the business office doing the same work as business office clericals and alternating as reception- ists. The medical record clerks and the business office clericals also work under the common supervi- sion of the senior business office clerk. Finally, the record establishes that, because of the small size of the Center, occasionally employees in the laboratory, dental, or X-ray area will have nothing to do during slack periods. On such occasions, those employees will be directed to assist the business office clericals with records and billings. Accordingly, under the special circumstances of this case wherein the Employer's employee complement is small, the two service and maintenance medical record clerks spend a considerable portion of their day working alongside and doing the same work as business office clericals, the senior business office clerk directly supervises the medical record clerks as well as the business office clericals, other unit employees occasionally work in 5 FamilV Doctor Medical Group, a Professional Corporation. 226 NLRB 118 (1976). See also Mercy Hospitals of Sacramento. Inc., 217 NLRB 765 (1975). Sisters of St. Joseph of Peace, 217 NLRB 797 (1975): Meharr, Medical College, 219 NLRB 488 (1975). 543 DECISIONS OF NATIONAL LABOR RELATIONS BOARD the business office doing business office work, and no union has indicated a willingness to separately represent the business office clericals, we find the business office clericals share a community of interest with the other employees sufficient to warrant their inclusion in the unit.6 It has long since been settled that the unit sought need only be an appropriate unit, not the most appropriate unit. 7 Accordingly, we will include the five business office clericals in the overall unit of the Employer's nonprofessional employees. In view of the foregoing, we shall direct an election by secret ballot in the following unit found appropri- 6 See South Station Liquor Store, Inc. d/b/a Berenson Liquor Mart, 223 NLRB 1115. 1116-17(1976). ate for the purposes of collective bargaining within the meaning of Section 9(b) of the Act: All regular full-time and part-time nonprofession- al employees, including service, maintenance, technical, and business office employees em- ployed at the June Buchanan Primary Care Center, Hazard, Kentucky; but excluding profes- sional employees, confidential employees, guards, and supervisors as defined in the Act. [Direction of Election and Excelsior footnote omitted from publication.] I Morand Brothers Beverage Co., 91 NLRB 409 (1950), enfd. 190 F.2d 576 (C.A. 7, 1951). 544